Normal labour and birth

Abstract

Normal birth is a common outcome for the ambulance service following an imminent birth dispatch. In 2008, the London Ambulance Service attended over 1000 imminent births calls, with the crew either in attendance for a birth, transporting prior to birth or the infant born before arrival of a crew. The majority were full-term, low risk pregnancies with a normal birth, and the mother having birthed previously (personal communication, London Ambulance Service, 2009). The aim of this paper is to review the issues of normal birth. It will explore the concept of normal birth and encourage practitioners to reflect on care after a normal birth. It discusses the physiology and mechanism of normal labour, birth and physiological placental expulsion. The paper will explore the ambulance clinician's role in securing and maintaining a normal birth outcome and explore care required for the woman, newborn infant and family. This paper will not discuss complications in pregnancy and during labour or in depth discuss birth, postnatal complications or newborn resuscitation. Ambulance personnel must follow the guidelines issued by the Joint Royal Colleges Ambulance Liaison Committee UK Ambulance Service Clinical Practice Guidelines (2006) (JRCALC, 2006).